Pain After Cycling

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I am a competitive cyclist in need of a left knee and hip replacement. There are times after a long, hard training ride that I am in a significant amount of discomfort. I rarely take the 500 mg naproxen I have and was wondering what else I could do to relieve the discomfort I'm in without giving up my Paralympic dream.?

—Michael, New York

In order to better answer your question, I'd need to know what underlying problem puts you in need of a joint replacement. But in general, you are probably aware that a long, hard training ride may contribute to further wear and tear of your hip and knee joints, so I hope you are under a physician's care to monitor the situation. You might also consider working with a physical therapist to make sure your joints are protected and your muscles are strong and balanced.

For short-term relief, you might consider taking a nonsteroidal anti-inflammatory drug (NSAID) such as naproxen or ibuprofen or indomethacin before your training, along with a medication to protect your stomach. For example, proton pump inhibitors (PPIs) such as lansoprazole (Prevacid), omeprazole (Prilosec), Nexium, or others reduce the secretion of stomach acid; antacids work by neutralizing acid.

In addition, tried and true tactics include a warm shower or warm compresses on the joints before training to relax muscles and facilitate joint motion. After training, if you have discomfort or knee or hip pain, and if your knee seems swollen, cold compresses for ten to 15 minutes should help. Best wishes for the Paralympics!

Last Updated: 12/21/2006

Dr. Rodanthi Kitridou is a rheumatologist and professor emerita of Medicine at the USC School of Medicine, Los Angeles County-USC Medical Center.

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